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Child-Pugh Class B or C Liver Disease Increases the Risk of Early Mortality in Patients With Hepatitis C Undergoing Elective Total Joint Arthroplasty Regardless of Treatment Status
CONCLUSION: Patients with HCV and a Child-Pugh Class B or C at the time of elective TJA had substantially increased odds of death, regardless of liver function, cirrhosis, age, Model for End-Stage Liver Disease level, HCV treatment, and viral load status. This is similar to the risk of early mortality observed in patients with chronic liver disease undergoing abdominal and cardiac surgery. Surgeons should avoid these major elective procedures in patients with Child-Pugh Class B or C whenever possible. For patients who feel their arthritic symptoms and pain are unbearable, surgeons need to be clear that the risk of death is...
Source: Clinical Orthopaedics and Related Research - March 24, 2023 Category: Orthopaedics Authors: Kyle H Cichos Eric Jordan Kian Niknam Antonia F Chen Erik N Hansen Gerald McGwin Elie S Ghanem Source Type: research

New recommendations aim to improve safety of pain-relieving spinal steroid injections
More and more people are seeking injections of anti-inflammatory steroid medications for back and neck pain. In 2011, the last year for which complete information is available, doctors pushed the plunger on 2.3 million steroid injections into the spine — and that’s just among people covered by Medicare. These injections deliver drugs that mimic the effects of two hormones, cortisone and hydrocortisone, to reduce inflammation and help relieve pain. When they work — they don’t always — such injections can bring profound relief. “If you are in severe pain with a ruptured spinal disc and you get a stero...
Source: New Harvard Health Information - May 7, 2015 Category: Consumer Health News Authors: Daniel Pendick Tags: Back Pain Drugs and Supplements anti-inflammatory steroid medications spinal injections spine steroid injections Source Type: news

EBN resources page
SIGN Apps for iPhone and iPad http://itunes.com/apps/signguidelines, https://play.google.com/store/apps/details?id=com.rootcreative.sign The SIGN app has recently been updated and now contains quick reference guides (QRGs) for:SIGN 136 Management of chronic pain SIGN 135 Management of epithelial ovarian cancer SIGN 134 Treatment of primary breast cancer SIGN 133 Management of hepatitis C The SIGN app has also had a complete re-design and now features:Optimisation for the latest operating systems Re-designed for improved legibility Send pdf button feature Split screen feature (ipad) Prevention of stroke in patients with atr...
Source: Evidence-Based Nursing - June 17, 2014 Category: Nursing Tags: Liver disease, General practice / family medicine, Hepatitis and other GI infections, Drugs: cardiovascular system, Pain (neurology), Stroke, Diet, Pregnancy, Reproductive medicine, Breast cancer, Gynecological cancer, Lung cancer (oncology), Radiotherapy Source Type: research

Short answer question case series: a dangerous cause of dyspnoea
Case vignette A 52-year-old man with hepatitis C and a remote history of recreational drug abuse presents with several days of shortness of breath, cough and malaise. He was seen at an outside hospital and diagnosed with pneumonia given his cough and shortness of breath. Subsequently, he was seen again and found to have a small abscess of his arm that was drained. On review of systems, he endorses nausea and generalised weakness but denies abdominal pain, chest pain, numbness, fever, headache or dizziness. On physical exam, he is afebrile but tachypnoeic, has decreased breath sounds at the bases, and has an appropriately h...
Source: Emergency Medicine Journal - July 19, 2013 Category: Emergency Medicine Authors: Woodfield, A., Runde, D., Jang, T. Tags: Poisoning/Injestion, Foodborne infections, Hepatitis and other GI infections, Pneumonia (infectious disease), TB and other respiratory infections, Cranial nerves, Headache (including migraine), Pain (neurology), Stroke, Drugs misuse (including addiction), Source Type: research